Fifteen Months

By Dr. Brown

BUSY! That’s the best term to describe 15 month-olds. Most are walking by this age, and if your child is not, he sure will be soon. You can hardly call your child a “baby” anymore. In fact, we now refer to them as “toddlers” because of their “toddling” gait. Fifteen month olds are full of curiosity and activity. They have no apparent sense of internal limits – so watch out. They sure can get into a lot of trouble.

Have you heard the term “terrible two’s”? Well, that really refers to this time now – your child’s second year of life. Why does this happen? Your curious and active child does not want to be told to stop or be inhibited in their new physical capabilities and curiosity, even though they really need your constant attention! This brings on tantrums and the like. Parents have to walk that fine line between keeping their child safe and allowing their child freedom to experience the world around them. Good Luck!

DEVELOPMENTAL PLAY

If your child is not walking yet, she will be soon. Although many children may have the physical capability to walk (as evidenced by their walking with mom or dad's help), some will not walk independently until as late as 18 months. Have your child practice a lot of walking with your help, giving your child less and less support as time goes on. Push and walking toys are good to use also. Being around other toddlers is a great stimulus to get kids to walk.

Speech begins to evolve more at this time. Try to play lots of fun games with your child. Games such as the "animal sound game" (what does the doggie say, etc) will engage your child. After she masters many animal sounds, you can play the body parts game, having her identify various body parts. Singing songs, especially songs with actions (itsy-bitsy spider, wheels on the bus, etc) are great ways to encourage speech and understanding.

If your child is walking by now, start giving her commands like “give mommy the book”, “hand me the cup”, etc. This is a great way to assess your child’s “receptive language” and stimulate your child’s speech. If your child is not walking, have her point to pictures in a book, or say “where’s daddy” to see if she looks to find him. Receptive language is always ahead of expressive language.

Continue to read to your child with simple picture books, pointing out and identifying the various objects. Learning to point is a big developmental milestone for your child. This will enable her to communicate better, express her wants, show interests, and socially interact with you. We like to make a distinction between “point to want” (an earlier milestone) versus “point to show”. Your child should begin to “point to show” to share an “interest” with you. Encourage this joint attention by showing him objects (doggies, balloons, etc.) and responding to any similar gesture your child makes. Peek-A-Boo is still a great game to play.

If you’ve already begun using sign language, continue! If not, you may want to consider it. There are several books where you can read about the topic as well as learn how to sign. Give this some serious consideration, even if you only use a few signs. Check the "Recommended Books" section - Special Topics, of our website for a recommendation.

Perhaps the most important advice I can give to you and your child’s play is to PLAY THE WAY YOUR CHILD WANTS TO PLAY. All too often, with good intention, we parents want to direct a child’s play to show them the right way, teach them, whatever. However, good intention doesn’t necessarily yield good results. Developmental specialists strongly suggest “following your child’s lead”. Don’t worry about finishing that book you’re reading – maybe your child wants to turn the pages to quick get to the end to find the doggie picture he saw on the previous page!

Social play begins to evolve at this time. Your child will want to interact with you and engage you in their play at this age. They are very observant - it’s great to see them mimic what you do: talk on the phone, brush hair, put shoes on feet, etc. If they are not doing this pretend play, try to encourage her to do so. Being silly is a great way to get a child’s attention.

Children like to just manipulate objects: opening, closing, putting things in, taking things out – all day long! It’s a good time to work with simple puzzles at this time including shape sorters to help their dexterity.

Your child could be completely on table foods by now and whole milk or substitute if appropriate (at least 16 ozs per day). You can continue to give your child jar foods to make up for any deficiencies she may have. Continue to avoid nuts, peanut butter, and things she may choke on. If you haven’t gotten rid of that bottle, now is a good time!

If you haven’t yet seen the "toddler appetite slump", you probably will soon. Some days your child may eat like there's no tomorrow, other days, she may not take a bite of food. Favorite foods may be frowned upon. Don't watch your child's appetite day to day, you've got to watch over many days. Make sure she gets some vegetables, some fruits, and proteins. Generally its no problem to get children to take breads and carbohydrates. You still have to make sure that your child gets exposed to plenty of different foods. You can't control what gets past your child's lips, but you can control what she is exposed to.

Feeding with family at a regular mealtime is important for socialization as well as eating encouragement. You should offer your child a spoon or fork to work with. This can be quite messy and at times your child may just hold the utensil as a prop and continue to use his more efficient hands. Good luck trying to feed your toddler – typically he’ll resist you, having to do it all by himself!

SLEEP

Bedtime can be difficult – toddlers often resist calling it quits for the day. However, you know better – your child needs sleep. Please try to be consistent with this. If your child see you wavering, they can use it to their advantage.

Your child should be sleeping through the night. That means 10-12 hours at night. This is the transition time where she may go down to one nap (sorry!). Follow your child’s lead on this. Your child should not be having anything to eat or drink in the middle of the night.

SAFETY

As usual, watch out for choking and poisonings. Children at this age are learning to open and close bottles - which opens a bigger array of possible poisonings. Poison Control telephone number is: 1-800/222-1222

It’s a good time to get down on your hands and knees to see the world as your toddler does. Check under furniture for any items that your exploring child may find and choke on. Gate stairs and other hazards. Its also a good idea to turn your hot water heater down to 120 degrees to avoid scalding. Close the bathroom door so your exploring child won't play in the toilet!

Be careful when holding hot liquids. Your mobile child may sneak up on you!

Kids like to climb at this age. Watch out for objects that they may climb on and tip over.

COMMON PROBLEMS

Toddler Appetite Slump

As mentioned above, your child may start having all sorts of changes with her appetite. Some suggestions about eating if your child is having a slump:

Teach your child to feed herself as soon as possible. Don't expect your child to finish her portion and don't put food into her mouth because it is open.

Put your child in charge of how much she eats.

Don't give her more than two snacks per day and limit juice intake.

Serve smaller amounts than your child may want to eat. Let her ask for more.

Don't make your child sit at the dinner table after everyone has left so that she can finish her meal.

Temper Tantrums

Temper tantrums commonly start showing up when your child becomes more independent and wants to make her own decisions. A lot of this independence starts when she begins to walk and move to where she wants to go. Telling your child “no” will commonly precipitate these protests or tantrums. During this curious time, try to not to use the word “no” very often. Instead, use tone of voice, call your child’s name, say “uh-oh”, or some other variation to stop your child from whatever. Re-direction is essential for these persistent ones.

Sleep Disturbances

Many children who had been great sleepers may begin to wake up in the middle of the night. Some of this may be attributed to teething, but also many children tend to go through another stage of separation anxiety wherein they need to check-in with a parent. Use whatever approach that you feel most comfortable with – reassuring your child is a good plan, but try not to be too friendly. Give your child a clear message that he should be sleeping.

Refusal to go to sleep is common at this age. Try to be consistent with your message and your routine.

WHAT TO EXPECT

Doctors Office Visits

Now that your child is older, she may start finally realizing what goes on at the doctors office. For the next year or so, the office visits may not go so well, as she protests being examined. Your child will take “cues” from you – try to not let him see that you think the doctor is scary. Has your child had his nap, or will the visit be during his naptime?

Exploring

Your curious toddler will want to get into everything. Baby proof the house and be prepared!

Language

Stimulate your child's language development as much as possible. See some of the above suggestions.

Social

Soon your child should start seeing other children on a frequent basis. Although they don't play together interactively, children engage in what's called "parallel play"; they watch the others, especially older children and begin to mimic their play. This is a great way for children to learn how to accomplish new developmental milestones. Other children are a great stimulus for your child.

Remember: PLAY THE WAY YOUR CHILD WANTS TO PLAY!!!!!

COVER TEST FOR VISION

Whenever you can think of it, try this test to see if your child's vision seems to be equal from both eyes:

When she's looking intently at an object, cover one eye with your hand, then cover the other. What you're doing is checking to see if she protests consistently. For example, if your child has a "weak" right eye, she'll probably allow you to cover that eye because she can still see well from the left eye. If you now cover her left or "good" eye, she may protest or push your hand away because things may appear blurry out of the right or "weak" eye. It's very likely that she'll protest whenever you do either eye, but if she consistently allows you to cover one eye and not the other, there may be a problem.

DENTAL

You should be wiping or brushing your child’s teeth. Use just plain water, a fluoride-free toothpaste, or less than a pea-sized bit of regular toothpaste. A great way to get your child involved is to have him watch you in your daily ritual, then one day offer him his very own brush. Likely, he will try to mimic you. After a while tell him, now mommy’s turn, so that he knows from the start that mommy has to finish the job! If your child drinks water, its best to have it supplemented with fluoride.

No bottles to bed (but you already knew that)!

AUTISM

If you have any concerns, please see the section below "Special Topics" - Autism. There is also a checklist on our website under the Autism Section – you can download the checklist “Developmental Screen for 15-18 month old children” and bring it into the office for review.